What is Type II Diabetes Mellitus?

What Is Type 2 Diabetes?

Type 2 diabetes, formerly known as non-insulin-dependent diabetes, occurs when the body is no longer able to use insulin effectively and gradually becomes resistant to its effects. It is a slowly progressing disease that goes through identifiable stages. In the early stages of diabetes, both insulin and glucose levels are elevated (conditions called hyperinsulinemia and hyperglycemia, respectively). In the later stages, insulin levels are reduced, and blood glucose levels are very elevated. Although few people are aware of this crucial distinction, therapy for type 2 diabetes should be tailored to the stage of the disease.

Risk factors for type 2 diabetes include aging, obesity, family history, physical inactivity, ethnicity, and impaired glucose metabolism. Type 2 diabetes is also a prominent risk of metabolic syndrome, a constellation of conditions that includes insulin resistance along with hypertension, lipid disorders, and overweight. For details, see the chapter titled Metabolic Syndrome.

What Are the Symptoms of Type 2 Diabetes?

The symptoms of diabetes are related to high blood glucose levels. They include:

1. Excessive urination, thirst and hunger
2. Weight loss
3. Increased susceptibility to infections, especially yeast or fungal infections of the skin and vagina

Extremely high blood sugar levels can lead to a dangerous complication called hyperosmolar syndrome, also known as hyperosmolar hyperglycemic nonketotic syndrome (HHNS), hyperosmolar hyperglycemic state (HHS), or hyperosmolar coma. Hyperosmolar syndrome is a life-threatening form of dehydration that can result from untreated high blood sugar levels. Hyperosmolar syndrome can complicate a severe acute illness, such as a stroke; it can also happen when poor fluid intake initiates dehydration. In some cases, hyperosmolar coma is the first sign that a person has type 2 diabetes. This dangerous condition causes confused thinking, weakness, nausea or more extreme symptoms such as seizure and coma.
When people with type 2 diabetes take medications to reduce blood sugar, sugar levels may drop below the normal range and cause low blood sugar (hypoglycemia). Symptoms of hypoglycemia include sweating, trembling, dizziness, hunger and confusion. Hypoglycemia that you do not recognize and correct can lead to seizures and loss of consciousness. You can correct hypoglycemia by eating or drinking something with carbohydrates, which raises your blood sugar level.

Type 2 diabetes affects all parts of the body and can cause serious, potentially life-threatening complications, including:

1. Atherosclerosis
2. Retinopathy
3. Neuropathy
4. Foot problems – Sores and blisters occur.
5. Nephropathy – Damage to the kidneys.

What Causes Type II?

People over 40 who are sedentary and overweight, especially with excess weight around the middle, are the most likely to develop Type 2 diabetes. People who have a family history of Type 2 diabetes and those with a Hispanic, Black, Native American, or Asian background are more likely to develop Type 2 when excess weight is gained.

People with Type 2 diabetes produce insulin but because of insulin resistance the insulin does not work well. Over several years of having the disease, they gradually stop producing insulin. Some 85 to 90 percent of all diabetes is Type 2. Treatments for insulin resistance Type 2 diabetes revolves around varied combinations of diet, exercise, medications, or insulin. Insulin resistance is best treated with weight loss, a healthy diet, and exercise.

Therapy for Type 2 diabetes individuals a wide range of medications that can enhance insulin production, reduce the liver’s production of glucose, sensitize the cells to insulin, and slow the digestion of carbohydrates to minimize the rise of blood sugars after meals. Because insulin production gradually fails in Type 2 diabetes, insulin can become necessary as part of the treatment plan.

Treatment For Type 2 Diabetes:

Specific treatment for type 2 diabetes will be determined by physician based on:

1. age, overall health, and medical history
2. extent of the disease
3. tolerance for specific medications, procedures, or therapies
4. expectations for the course of the disease
5. patients’ opinion or preference

The goal of treatment is to keep blood sugar levels as close to normal as possible.
Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare. Treatment of diabetes is an ongoing process of management and education that includes not only the person with diabetes, but also healthcare professionals and family members.

Often, type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise alone. However, in some cases, these measures are not enough and either oral medications and/or insulin must be used. Treatment often includes:

Proper Diet

1. weight control
2. an appropriate exercise program
3. regular foot inspections
4. oral medications, other medications, and/or insulin replacement therapy, as directed by your physician
   There are various types of medications that may be used to treat type 2 diabetes when lifestyle changes such as diet, exercise, and weight loss are not effective. Oral medications of several different types are available, with each type working in a different manner to lower blood sugar. One medication may be combined with another one to improve blood sugar control. When oral medications are no longer effective, insulin may be required.
5. regular monitoring of the hemoglobin A1c levels
   The hemoglobin A1c test (also called HbA1c test) shows the average amount of sugar in the blood over the last three months. The result will indicate if the blood sugar level is under control. The frequency of HbA1c testing will be determined by your physician. It is recommended that testing occur at least twice a year if the blood sugar level is in the target range and stable, and more frequently if the blood sugar level is unstable.
6. Untreated or inappropriately-treated diabetes can cause problems with the kidneys, legs, feet, eyes, heart, nerves, and blood flow, which could lead to kidney failure, gangrene, amputation, blindness, or stroke. For these reasons, it is important to follow a strict treatment plan.
   Advances in diabetes research have led to improved methods of managing diabetes and treating its complications. However, scientists continue to explore the causes of diabetes and ways to prevent and treat the disorder. Other methods of administering insulin through inhalers and pills are currently being studied. Pancreas transplants are also being performed.